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Medications in Drug Treatment: Tackling the risks to children – one year on

A new research report from the charity Adfam, launched in the House of Lords today (24 November), has revealed that far more children than previously thought are dying and being hospitalised after ingesting medications prescribed to treat their parents’ drug addiction.

The report, Medications in Drug Treatment: Tackling the risks to children – one year on found that in the ten years to 2013, at least 110 children and teenagers aged 18 and under in the UK died from the toxic effects of opioid substitution therapy (OST) medications used primarily to help people overcome heroin addiction. In this time, at least 328 children in England were hospitalised and diagnosed with methadone poisoning. Of the 73 deaths in England and Wales, only seven resulted in Serious Case Reviews.

Since Adfam first reported on this tragic phenomenon in 2014, these cases have continued to occur, with at least three new Serious Case Reviews in the last year. Whilst in many cases children were thought to have consumed the medications accidentally, some were deliberately given them by their parents in a misguided attempt to help soothe or send them to sleep. The mortality statistics also show the majority of fatal poisonings involve older, rather than younger children – but little is known about how or why these incidents occur.

Opioid substitution therapy is proven to reduce dependence on street heroin, and by doing so it saves lives, improves health and wellbeing and cuts crime. The rightful place of these medications in addiction treatment is not at issue. Nonetheless, the newly identified number of child deaths and hospitalisations makes it imperative that the risks they pose to children are better addressed and future incidents prevented.

Adfam is calling for all incidents involving a child’s ingestion of these medications to be fully investigated and recorded – and analysed centrally by government, with the learning shared with local services. The wide range of professionals who come into contact with parents and carers prescribed OST medications including drugs workers, social services, GPs, pharmacists, midwives, school nurses, the police and probation staff must be trained about the potential harm these medications pose to children, and services must work together and share information more effectively to minimise risk. Gaps in knowledge remain including the number of parents allowed to take these medications home, and little research has been conducted into how many parents are administering their substitute medications to children. Parents prescribed these medications must also be educated about their potentially fatal risk to children, and given a secure box to store their medications.

Vivienne Evans OBE, Adfam Chief Executive, said: “The lessons from previous tragic cases have not been heeded, and a year after we called attention to the issue, children are still dying. The vast majority of parents prescribed these medications will use them safely and appropriately – but the number of children now identified as having been harmed lends the issue even greater urgency. Systemic and cultural failure means services are still not working closely enough to safeguard vulnerable children.”

Sue Bandcroft, a substance misuse manager who worked on one of the Serious Case Reviews, said: “This report, together with Adfam’s work training local authorities, has highlighted the pressing need for networking and multi-disciplinary training for the full range of professionals working with families with a parent prescribed opioid substitution medication. Even in areas of good practice, there is still room for improvement and an urgent need to ensure all agencies are involved. I hope these findings

inspire the workforce to take proactive action to tackle this problem and stop any more tragic cases occurring.”

By the end of 2015, Adfam will have trained 19 local councils to reduce the risks to children posed by these medications, and hope to continue this crucial work in 2016.

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